title: Variation in the relationship between BMI and survival by socioeconomic status in Great Britain.
abstract: We investigate the relationship between obesity and survival, and the extent to which this relationship varies by socioeconomic status (SES). The underlying model is based on the "Pathways to health" framework in which SES affects health by modifying the relationship between lifestyles and health. We use data from the British Health and Lifestyle Survey (1984-1985) and the longitudinal follow-up in June 2009, and run parametric Gompertz survival models to investigate the association between obesity and survival, also accounting for interactions between obesity and both age and SES. Generally we find that obesity is negatively associated with survival, and that SES is positively associated with survival, in both men and women. The interactions between obesity and SES predict survival among women but not among men. Obesity compared with normal weight is associated with a reduction in survival of 3.3, 3.2 and 2.8 years in men aged 40, 50 and 60 years, respectively. Corresponding numbers among women in the lowest SES group are 13.1, 9.7 and 6.1 years, respectively; in the highest SES group they are 6.2, 3.1 and 0.1 years, respectively, a difference of approximately 6 years between the highest and lowest SES groups.
authors.affiliation: Statistics Norway, Research Department, Pb 8131 Dep, 0033 Oslo, Norway. Electronic address: Jonas.kinge@ssb.no.
authors.forename: Jonas Minet
authors.initials: JM
authors.lastname: Kinge
authors.affiliation: University College London, Department of Applied Health Research, Gower Street, London WC1E 6BT, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morris
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004739:England / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000191:economics / Q000401:mortality; D017678:Sex Distribution; D012923:Social Class; D064890:Social Determinants of Health; D016019:Survival Analysis
keywords: Mortality; Obesity; SES; Socioeconomic status; Survival; Survival analysis